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D2 S PAR 1 > PAR 1 Pharmacology > Flashcards

PAR 1 Pharmacology Flashcards

1
Q

Ketoacidosis cause and tx

A

cause: LOW insulin

tx: insulin

increased ketones lower the pH and increase glucose, leading to hyperglycemic crisis

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2
Q

Sever HYPOglycemia treatment

A

recombinant glucagon

stimulates the liver to release glucose into the blood

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3
Q

Sulfonylureas

A

increase insulin release by blocking K+/ATP channels in beta cells

HIGH RISK of HYPOGLYCEMIA

  • chlorpropamide
  • glyburide
  • glimepiride
  • glipizide
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4
Q

What should you avoid prescribing in patients on sulfonylureas?

A

NSAIDs– could increase hypoglycemia

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5
Q

Meglitinides

A

“-glinide”

increase insulin release from beta cells

control of post-prandial glucose

  • repaglinide
  • nateglinide
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6
Q

Biguanides

A
  • metformin

does NOT affect insulin secretion– NO risk of hypoglycemia

Stimulates AMPKs to reduce blood glucose
- (AMP activated protein kinase)

LACTIC ACIDOSIS RISK

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7
Q

Thiazolidinediones

A

“-glitazone”– rosiglitazone, pioglitazone

Specifically bind PPAR𝝲

increase insulin sensitivity– makes a low concentration have the same effect as a higher concentration

Metabolized by P450

Black box warning to monitor for heart failure signs after starting therapy

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8
Q

Ultra short insulins

A

aspart
lispro
glulisine

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9
Q

Short acting insulins

A

normal insulin

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10
Q

intermediate acting insulins

A

NPH
lente

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11
Q

Long acting insulins

A

detemir
degludec
glargine

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12
Q

What drugs have the potential to cause hypoglycemia?

A
  • insulin therapy
  • sulfonylureas
  • meglitanides
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13
Q

Peptide incretin drugs

A

bind GLP-1 receptors (act like GLP-1)

decreases glycogenolysis caused by glucagon

  • liraglutide
  • albiglutide
  • dilaglutide
  • exenatide
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14
Q

Which peptide incretin drugs are resistant to hydrolysis by DPP4?

A

liraglutide
exenatide

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15
Q

DPP4 does what?

A

hydrolyzes (inactivates) incretins (so insulin is lower)

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16
Q

DPP4 inhibitors

A

increase insulin and lower blood glucose

  • sitagliptin
  • saxagliptin
  • linagliptin

sitagliptin also inhibits inactivation of GLP-1

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17
Q

Colesevelam hydrochloride [Welchol]

A

bile acid sequestrant

  • developed to lower cholesterol, now approved for type II diabetics who are taking other medications

lowers HbA1c and LDL cholesterol

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18
Q

Na/Glucose co-transport 2 inhibitors

A

“-flozin”– canagliflozin, dapagliflozin, empagliflozin

Block glucose reuptake in the kidneys by inhibiting SGLT2

Do NOT use in patients with compromised kidneys

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19
Q

Somatostatin action

A

delta cell secretion

inhibits TSH and GH release from pituitary

inhibits insulin AND glucagon release

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20
Q

Somatostatin drug

A

ocreotide

inhibit insulin in insulinomas

inhibits glucagon in glucagonomas

can also tx acromegaly

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21
Q

alpha-glucosidase inhibitors

A

acarbose, miglitol

reduces uptake of carbohydrates and decreases post-prandial glucose rise

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22
Q

diazoxide

A

potent HYPERglycemic actions

inhibits insulin secretion, but does NOT inhibit insulin synthesis

tx for inoperable insulinomas

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23
Q

Levothyroxine

A

synthetic T4

24
Q

Liothyronine

A

synthetic T3

25
Thiourelyenes
inhibit iodination and coupling of iodine (decrease production of active thyroid hormone) PTU, methimazole (Tapazole), carbimazole (Neo-mercazole)
26
PTU blocks what other rxn different from the other thiourelyenes?
PTU also inhibits conversion of T4 to T3
27
Which thiourelyene should you use in a pregnant pt?
PTU-- because it does NOT cross the placenta, whereas methimazole (Tapazole) does.
28
Thyroid storm treatment
Iodine (KI) - Iodine (KI) also used as a pre-op treatment
29
Iodine (KI) MOA
- inhibits ALL I- metabolism by the thyroid gland and blocks the release of T3/T4
30
Who can you give reactive iodine to?
Adults over 35, no women of child-bearing age - beta radiation destroys parenchymal cells of gland
31
Hyperthyroidism treatments (classes)
Thiourelyenes Iodine (KI) Radioactive Iodine
32
PTH therapeutics
raise plasma calcium levels, treats hypoparathyroidism hPTH (Teriparatide) Vit. D and dietary Ca supplement
33
Stress releases cortisol, which will....
suppress pituitary function, so TSH is not released -- causes hypothyroidism
34
Where is calcitonin secreted from?
parafollicular C cells of the **thyroid** causes a shift to the inactive form of Vit D - decreases Ca reabsorption by kidneys - decreases bone resorption
35
Hypercalcemia treatment?
- calcitonin - hCT - prednisone
36
NSAIDs and aspirin can do what in a hyperthyroidism patient?
increase T4 levels
37
Calcitriol
made in kidneys, active form of Vitamin D increases calcium and phosphate induces synthesis of calbindin
38
Calcitriol therapeutics treat what?
- nutritional rickets - metabolic rickets - osteomalacia - hypoparathyroidism
39
Cinacalcet (Sensipar)
calcimimetic-- **binds allosterically to CaSR... causes PTH suppression at lower [Ca2+]
40
Bisphosphonates
"-dronate" inhibit bone resorption-- lower plasma calcium poor absorption, so you have to take on an empty stomach-- can cause erosive esophagitis
41
Which bisphosphonates do not treat hypercalcemia effective orally and need a 4-24 hour infusion instead?
etindronate pamidronate
42
etindronate brand
Didronel
43
alendronate brand
Fosamax
44
pamidronate brand
Aredia
45
ibandronate brand
Boniva
46
risendronate brand
Actonel
47
zolendronate brands
Recast, Zometa
48
Denosumab
RANK ligand inhibitor monoclonal antibody tx: osteoporosis, metastasis to bone, giant cell tumor of bone
49
Cholecalciferol
Vit D3 (fish oils)
50
ergocalciferol (after irradiation)
vit D2
51
Calcipotriol
DONOVEX-- psoriasis
52
Dihydrotachysterol
reduced D2-- **osteoporosis**
53
Paricalcitol (Zemplar)
reduces **PTH Secretion**
54
22-oxacalcitriol
Suppresses **PTH gene expression**
55
Calcitriol brand names
Calcijex, Rocaltrol

D2 S PAR 1 (2 decks)

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